Extraoral



March 13, 1945. R. w. TAYLOR EXTRA-ORAL FRAGTURE APPLI'ANCE Filed May 14 194s INVENTOR Patented Mar. 13, 1945 UNITED STATES VPATENT OFFICE l 2371.197 f EX'rRAoRAL FRACTURE APPLIANCE Ralph W. 'raylmffnnitea states Navy Application May 14, 1943, Serial No. 486,943

(ci. 12s-sv) (Granted under the act vof March 3, 1883, as amended April 30, 1928; 370 0. G. 757) 4'7 Claims.

The present invention relates to extra'-oral fracture appliance which is usedwhen the superior maxillae or the mandible bones of the skull are fractured, and said appliance assures a complete iixation of the injuredfragments with relation to the other parts of the skull.

The device comprises a kind of framework structure which may be partially mounted in a plaster head-cap which is worn by the patient and is provided with one or more intra-oral fracture splints which are mounted on the frame- -work of the appliance, said splints insuring a complete fixation of the injured skull bones with reference to the skull itself.

Various parts `of the fracture appliance are adjustable for purposes which will be described hereinafter as the specicationproceeds, which enables the device to be applied to various sizes of individuals who require the use of such an invention.

In the accompanyingdrawing formingy a part l of the specification:

Fig. 1 is a front view of the eXtra-oral fracture appliance comprising the subject matter of the present invention.

Fig. 2 is a vertical section taken on line 2-'-2 of Fig. 1.

Fig. 3 is a horizontal sectional view of the appliance taken on line 3--3 of Fig. 1.

Figur 6 is a frontal view of a pairrof opposed 'l intra-oral fracture splints taken on line 8 6 of Fig. 2.

' Fig. 'l is a central vertical section of a movable attachmentforming part of the present fracture appliance taken on line I-I of Fig. 2.

Fig. 8 is a similar vertical section 0f the mov able attachment taken on line 8-8 of Fig. 3.

The present invention I comprises a substan# tially horizontal b'ar 2 which is curved as shown in Fig. 3, which bar carries adjustably mounted thereon a movable attachment 3. The movable attachment 3 carries an adjustable intraoral splint 4 which isnormally inserted in the mouth of the patient and placed in engagement with the upper teeth as illustrated in Figs. 2 and 6 of the drawing.

Two vertical bars and 8 are mounted in the ends of the horizontal bar 2 as seen in Figs. l, 2 and 3 ofthe drawing clearly. At the top of these vertical bars 5 vand 8 area pair' of opposed horizontal curved bars 'I- and 8 which are adjustably mounted in the respective vertical bars 5 andv 8 by means of the slots 3 and I0 and the lock nuts II and I2.` These horizontal bars I and 8 are in turn mounted in a plaster head-cap I3 shown in 8 respectively are left protruding outside the head-cap I3, as shown, so that the'saidbars may be adjusted with respect to the opposed vertical bars 5 and 6 locked in a suitable position by means of the nuts II and I2, as is at once understood.

It is seen from the drawing that when the superior maiiillae of the patient are injured that the intra-oral splint`4 is inserted in the mouth of the patient just outside and in contact with the teeth and secured by wire to said teeth, using the vertically positioned metal prongs or loops I 8 which are mounted on the splint4. The splint l 4 comprises the horizontal bar portion II which along said bar 2 ras shown in Fig. 1 of the draw- Y ing, and the movable attachment 3 and the intra-oral splint 4 are of course adjusted to suit the requirements of the particular individual pan tient usingthe device.

It is evident from what has 'been' said that the composition plate I8 is adjustable by means of the centric pin I9 toward and away from the head of the patient and with respect to the casing 2|. The splint 4 and the plate I8 are also adjustable in a rotary directionas seen in Fig'. 1,

by means of the centric pin' I9 -and the splint locking screw 23, that is to say, when the centric 'pin is operated, in a longitudinal direction as `seen in Fig. 2- and in a rotary direction as seen in Fig. 1 that the needed adjustments vof the splint 4 may be made with relation to theindividual patient being treated. f l' Moreover, theplacement of the splint 4 with reference to'the mouth of the patient and in respect `of the two vertical bars 5 and 8 is also accomplished by means of the movable attachment casing 2'I along the horizontal curvedbar 2, and the locking screw 23 locks these two lastnamed adjustments by a single operation of said screw.

The nature of the casing 2I and its appurtenant lparts is clearly shown in detail in Figs. 7 and 8 of the drawing, in which appears the centric pin I9 which passes slidably and rotatably throughrthef casing;Y 2 i. The: curved? horizontal bar 2 alsopasses revolvably through'the casing 2|. On the bottom of the casing 2| appears a threaded screw 24. Above centric pin I9 is an upper gripping piece 25, the natureof-cwhichris y clearly shown in the Figs. 7 and 8 of the drawing, and beneath the centric pin -I9 is=anfl=inter mediate shaped gripping parla-.26 .whicnrides on the horizontal curved bari2 as shown and also bears against the centric pin I9.

Beneath the curved bar 2 is athird or bottom gripping member 27 whichengagesmmitszupper '20eme-attachment slidably and revolvably mounted face against the under surface'ofthe said bar f'sZand pn itsibottom bears: against nut; 24. Si tfwill .r bei' seen; v`thatrtheptighteningraction of ithefrlocking -screwf23znethe casingaZ Ieinsures they locking cof rthe `,casing-..2 I-:onfztherbar .Zrbyrmeansrof the ,parts V26 `acodl'l ,rwhiiei atrthe same-,time thefsame action.insures=vthedocking tof: the :centric pin'r'i 9 fwwithinethe casing! I ,.'so thattwhen theintraforal splint 4 is properlyvfadjnstedgthe :eentric.pin.-I9 yalso aidustedeand: the casingcZI iadjustedaa'long theihorizontal tbarf-.2f-thatf by? a sing-lesaction :of fthelockingv2 screwa23. yithetor-al :splint .4 isziixed @withrelatiomto.,thechorizontalrbarr Zaandthe -uprightstcandi 6. Also byrameansazof ther slots: 9 :Yandel 0,-.and-doclenuts Iliand -I2v,the;.oralf splint 4 is adjusted and locked in desired positionfwith areferenceftoethe headecaptl. A inigthe .Figure -s6fis shown aedoublefpainofeinf traforal .-:splintswlaande28a` which` are .intendedl for ruse yixzvhenathe :uppemmaxilia-ry .e-lcenes.V and fthe mandiblesbonesf are-.both broken, or-,the-mandible bones. alonefareainjured. z-Theenppere-splint 4 as .,beforerstatedfis. .carriedf-at Ufomtlie; centric :pin 4LiL-and theasplintA :is -fwired Jtofithe.;,upperlrow Uof teetltof thegpatientfand:alleadjustments.:made

,zbyfmeans ofi thev movable: attachment. .3 ,-z-and,l the lvertical barsfi andei.;andatherhorizontal' bars 'I- and 8 and lock nutsrIIandsH.

Thereafter the-.lowerzmetalssplintf28- which is .asimilantofsplintedgexcept thattsj placed in; -an .invertedpositionmith;thewire.loops28, Z-Szpointring downward?asdnrliigaj-.is ffwired to ;the 'lower ...setmftteethaof-gthepatient. .-The.lower.- splinti28,

,-tiomplaque -18, '.sineel the l:splint 28.;` is. ,attached cto the -.upper.v splint 4 by means-, -fpreferablyof means. Also some of theselbandssuchzas maare ,placed vertically nn the.fl0opsiI-Eufanda2-S, While otherslmay .beplaced diagonally.- asaBI one `:set l.of .the t bands being @mounted upon .tl-ie..other zv if ,.necessary.

.Infthis waytwhentthe mandiblaor loweriaw bones; of Al.the v,iziatient :are 2injured; they ican be xedlyyheld with` relation gto the zapper eportion .i of-,thekulL and uthe'.y teeth of :both jawsf .can ,tbe .placeddn ..prnperaocclusionf with: respect. to ,each A.;o.,tl:1er. .-Attenton Lis :calledtto the,.,fact that the plaque .vlaiistoftenzmadepf transparent material, c.and"thatrthaerlishaped:bart IJ; isjnotconlyfformed preferably integral with the-cplaquarbutimetal vzreinforcernentfsuch 1as=shownat2 maybeadded to theabar f I-Ttto @insureaag-:goodfstrong land estii a mounting. of :the .-.splintvII-znnethe .centric `pin f I 9 @and :arcuate-bari It. iseev-ident Ethattthis concarries the superior maxillae if fractured, but may be called upon to also carry the weight of the lower jaw, and lower splint 28 as well.

From which it is seen that I have devised a very useful and novel extra-oral fracture appliance,

for the purpose intended.

The invention described herein may be manufacturedaarid used bja'and-fort the...Government of the United vStates of 'America for governmental purposes without the payment of any royalties ll5. ed .to lbemxedlyimounted on the forehead of a patient, a pair f opposed vertical bars each ad- .:rjustably mounted on one of the said curved bars, a curved horizontal bar lI'lxedly mounted on the ,'lowerfends f-theopposed vertical bars, a mov- :.1@tithe-.horizontalzcurvedlbar; anfintra .-.oral splint adaptedftofbetmountedraroundfaesetrof teethfof. a @patient-fa composition carryingg-platemnountedton v.the saidfsplinmaicentric;pin slidablyiandtrevolv- 25...ablymounteddnfthefmovablei-attachment fon Ithe purpose of adjusting: therintra-,oraltsplint-tot.the i'..teet11. of'ithe patient, andimeansrforriadjustably lockingl the. centricppinL-n ,the frricwab-le.-.attach unent, and for adjustablyflockingsaidattachment .30 the horizontally curved bar.

2.fIn 4:an extra-.oral zfracture :appliance fior facial. bonesfappairipf. uppe'noppesed: curvedrbars s adaptedtorbe y xedlyfmounted .lonfzthe-foreheadz-of a patient, an intra-oral:splintradapted '1to1-be v.,means'for.adjustingzsad splintr inwardlyaandnutvwardly @with reference stosaidliteetligmeans:` for radjustingsaid splint 1vertically-jin'.- relationfosaid I pair of -upper ,opposed i .curved ibars,.means for 40 rotatably adjusting said splint on said.-teeth;.=and

means .comprising a :substantially irigid fmember having a pair of vertical barsslidably; secured radjacent. .their upperL ends: tossaidppair fof fnpper rv,oppesed .curved fbars.fandaa..single :curved `bar,

'firmly secured to the lowei'rendszoffzsaid, pairqof vertical bars, upon-which:.isslidably supported said splint for adjustment thereof in aI-.lateral direction '.with;l reference :t0 @the Ivertical vcenterline of the patients.-set.of.fteeth. l

In :an `feXtra-oral fracture appliance for ,-facal-.rbones, a.pair.xoft.upper curvedrbars :adapt- ..ed toabefiixedlyfmounted onfthe forehead ofthe patient, by means of a-,plaster head-piecegan intra-oral splint @adapted 1 toeibe fmounted around y55..,a,-set\of .teeth of ha `patienhraflower horizontal ...arcuate.- bar. shaped to conformar/ith thegeneral shape of the face of a patient, a movable attachlnient rotatablyfand: slidably; mounted on said ar- .,cuate bar, rotatably.mountedeadjestable means 60 carriedin thermevable attachment, .and attached .to..tlielintra-oral. splint .l fori adjusting: the splint inwardly` and outwardly with reference :to .f the patients. teeth ,ff and adjustable-.lockingmeans for .praising and,iloweringithe:horizontalfsarcuate @bar :with reference ato. thernfppermpaireof curved bars -V.inforder to ada'ust'rthe :oralssplintverticallyrdn relation ,toathe plaster ...head-piece used :onu the head .o-f;the .patient.

Iimovable .attachment A:for r@extra-oral .fractureapplianca.comprisingz'a hollowcylindri Astructicn is.,irnportantsincei.thessplint-Afnot only 15V-fing formeddnadirecton frninetytdegreeswith reference to the rst-named pair, and adapted tc slidably and rotatably receive a centric pin therein, an upper gripping member within vthe casing adapted to bear upon the centric pin, an intermediate gripping member within the casing adapted to bear against both the centric pin and the arcuate bar, a lower gripping member bearing against the latter, a closure nut mounted in the lower end of the casing, a locking screw threaded into the upper end of the casing, for the purpose in conjunction with the gripping members, of locking the centric pin and the arcuate bar in adjusted. relations in the casing.

5. In an extra-oral fracture appliance for facial bones, a pair of upper curved bars xedly mounted on the forehead of a patient, an intraoral splint mounted around a set of teeth of the patient, a centric pin connected with the said splint, a horizontal arcuate bar, a movable attachment mounted on the arcuate bar, comprising a hollow cylindrical casing having a pair of opposed apertures therethrough adapted to slidably and rotatably receive the arcuate bar, a second pair of opposed apertures in the walls of the casing formed in a direction of ninety de'- grees with reference to the first mentioned pair, and adapted to slidably and rotatably receive the centric pin therein, an upper gripping member within the casing adapted to bear upon the centric pin, an intermediate gripping member within thecasing adapted to bear against both the centric pin and the arcuate bar, a lower gripping member bearing against the latter, a closure nut mounted in the lower end of the casing, a locking screw threaded into the upper end of the casing, for the purpose in conjunction with the gripping members oflocking the centric pin and the arcuate bar in adjusted relations in the casing, and adjustable locking means for raising and lowering the arcuate bar with reference to the upper curved bars, and adjusting the oral'splint vertically in relation to the said upper bars.

6. An extra-oral fracture appliance as in claim 3 in combination with a lower intra-oral splint adapted to be mounted around the lower set of teeth of a patientz and means for securing both intra-oral splints to the patients teeth, and to each other. j

7. An extra-oral fracture appliance as in claim 5 in combination with a lower intra-oral splint adapted to be ymounted around the lower set of teeth of a patient, and means for securing both intra-oral splints to the patients teeth, and to each other.

RALPH W. TAYLOR. 

